1

Dance and Movement Therapy Holds Promise For Treating Anxiety and Depression, as well as Deeper Psychological Wounds

A few years ago, framed by the skyline of Detroit, a group of about 15 children resettled as refugees from the Middle East and Africa leapt and twirled around, waving blue, pink and white streamers through the air.

The captivating scene was powerfully symbolic. Each streamer held a negative thought, feeling or memory that the children had written down on the streamers. On cue and in unison, the children released their streamers into the air, then sat down nearby. Then they gathered up the fallen streamers, which carried their collective struggles and hardships, threw them in a trash can and waved goodbye.

The children were participating in a dance therapy activity as part of our team’s research program exploring body-based approaches to mental health treatment in people resettled as refugees.

In 2017, our lab – the Stress, Trauma and Anxiety Research Clinic – began piloting movement therapies to help address trauma in refugee families. We are learning that movement may not only provide a way to express oneself, but also offer a path toward healing and lifelong strategies for managing stress.

Silhouette image of a participant engaging in streamers activity described in story
Dance and movement therapy offers a self-empowering mind-body approach to mental health treatment.
David Dalton, CC BY-ND

On average, every year about 60,000 children are resettled as refugees in Western nations. Now, the refugee crisis resulting from the U.S. withdrawal from Afghanistan is bringing renewed attention to their needs. The UN Refugee Agency estimates that 6 million Afghans have been displaced over the past 40 years, and a new wave of tens of thousands are now fleeing from Taliban rule.

I am a neuroscientist who specializes in understanding how trauma reshapes the nervous system of developing youth. I use this information to explore creative arts and movement-based therapies to treat stress and anxiety. The instinct to move the body in expressive ways is as old as humanity. But movement-based strategies such as dance therapy have only recently been given much attention in mental health treatment circles.

As a dancer myself, I always found the nonverbal emotional expression offered through movement to be incredibly therapeutic – especially when I was experiencing significant anxiety and depression in high school and college. Now, through my neuroscience research, I am joining a growing number of scholars working to bolster the evidence base supporting movement-based interventions.

One mind and body

During the COVID-19 pandemic, the incidence of anxiety and depression doubled in youth. As a result, many people are searching for new ways to cope with and handle emotional turmoil.

On top of the pandemic, conflicts around the world, as well as climate change and natural disasters, have contributed to the growing global refugee crisis. This demands resources for resettlement, education and occupation, physical health and – importantly – mental health.

Interventions that offer physical activity and creativity components at a time when children and people of all ages are likely to be sedentary and with reduced environmental enrichment can be beneficial during the pandemic and beyond. Creative arts and movement-based interventions may be well-suited to address not just the emotional but also the physical aspects of mental illness, such as pain and fatigue. These factors often contribute to the significant distress and dysfunction that drive individuals to seek care.

Neuroscientist Lana Ruvolo Grasser does a tension-and-release exercise with study participants.
With outstretched arms, neuroscientist Lana Ruvolo Grasser performs a tension-and-release exercise with her study participants.
David Dalton, CC BY-ND

Why dance and movement therapy?

Body movement in and of itself is known to have a multitude of benefits – including reducing perceived stress, lowering inflammation in the body and even promoting brain health. In fact, researchers understand that the majority of our daily communication is nonverbal, and traumatic memories are encoded, or stored, in nonverbal parts of the brain. We also know that stress and trauma live in the body. So it makes sense that, through guided practices, movement can be leveraged to tell stories, embody and release emotions and help people “move” forward.

Dance and movement therapy sessions place an emphasis on fostering creativity and adaptability in order to help people develop greater cognitive flexibility, self-regulation and self-direction. This is especially important because research shows that early-life experiences and how children learn to cope with them can have a lasting impact on their health into adulthood.

According to the Child Mind Institute Children’s Mental Health Report, 80% of children with anxiety disorders are not receiving the treatment they require. This might be due to barriers such as clinician availability and cultural literacy, cost and accessibility, and stigma surrounding mental health conditions and treatment.

An ice-breaker exercise involving tossing strings of yarn to one another
In this ice-breaker exercise, study participants created a dream catcher by tossing strings of yarn to one another, introducing themselves and then tossing the string to another child across the room.
David Dalton, CC BY-ND

We are finding that dance and movement therapy and other group behavioral health programs can help fill important gaps. For instance, these strategies can be used in combination with services people are already receiving. And they can provide an accessible and affordable option in school and community settings. Dance and movement therapy can also instill coping skills and relaxation techniques that, once learned, can last a lifetime.

But does it work?

Our research and that of others are showing that dance and movement therapy can build up children’s sense of self-worth, improve their ability to regulate their emotions and reactions and empower them to overcome obstacles.

Much like yoga and meditation, dance and movement therapy has, at the root of its practice, a focus on deep breathing through the diaphragm. This intentional breathing movement physically pushes on and activates the vagus nerve, which is a large nerve that coordinates a number of biological processes in the body. When I work with kids, I call this form of breathing and nerve activation their “superpower.” Whenever they need to calm down, they can take a deep breath, and by engaging their vagus nerve, they can bring their bodies to a more restful and less reactive state.

[Get the best of The Conversation, every weekend. Sign up for our weekly newsletter.]

An analysis of 23 clinical research studies indicated that dance and movement therapy may be an effective and appropriate method for child, adult, and elderly patients experiencing a wide array of symptoms – including psychiatric patients and those with developmental disorders. And for both healthy individuals and patients, the authors concluded that dance and movement therapy was most effective for reducing the severity of anxiety compared with other symptoms. Research from our team has also shown promise for the benefits of dance and movement therapy in reducing symptoms of post-traumatic stress disorder and anxiety in youth who resettle as refugees.

We have scaled up these programs and brought them into the virtual classroom for six schools throughout the metro Detroit region during the pandemic.

Perhaps the most promising evidence for dance and movement therapy isn’t, as the saying goes, what the eyes cannot see. In this case, it is what the eyes can see: children releasing their streamers, their negative emotions and memories, waving goodbye to them and looking ahead to a new day.The Conversation

By Lana Ruvolo Grasser, Ph.D. Candidate and Graduate Research Fellow, Wayne State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.




Can We Help Young Brains Fight Off Anxiety?

By Jill Suttie | Greater Good Magazine

Anxiety is one of the most common childhood mental disorders. About 7% of children suffer from it at any given time, with nearly 1 in 3 adolescents experiencing it sometime during their teen years.

For an anxious child, seemingly normal activities can be hard. Worried kids have trouble adjusting to school, making friends, and learning. They can feel inhibited, avoiding challenges by running away or retreating into themselves. While parents may feel desperate to help, their approaches can backfire. For example, trying to talk kids out of their feelings or keep them away from anxiety-producing situations may inadvertently make the anxiety worse.

To help anxious kids, clinicians have developed science-based treatments, like cognitive-behavioral therapy, to alleviate symptoms. But the treatments can be cumbersome and expensive, and they don’t always work. Anxiety in kids as young as preschool-aged can be a sign of future trouble—a precursor to later disorders, like social anxiety, phobias, or obsessive-compulsive disorder. But less is known about how to stop anxiety in its tracks at very young ages, when kids may not even have the cognitive capacity to benefit from the treatment.

What if very young kids could be inoculated against anxiety somehow, sparing them from a future of worry and inhibition? A new line of research conducted by Kate Fitzgerald, professor of Psychiatry and Obstetrics at the University of Michigan, suggests this may be possible.

Fitzgerald has been studying very young children with anxiety symptoms and making important discoveries about the brain markers for childhood anxiety. Building on this work, she and her team have created a training program for young children aimed at increasing their cognitive capacities, helping to lessen their anxiety—both immediately and, possibly, in the future.

“We hope our work will show that childhood anxiety is not inevitable, but might be prevented with the right intervention,” says Fitzgerald. “So far, it’s looking promising.”

The neuroscience of anxiety

When we face challenging or scary situations in life, our brains naturally go into action. The amygdala sends out neurochemicals (like adrenaline) to make our hearts pound and prepare our bodies to “fight-flight, or freeze” in case of danger. At the same time, the frontal lobes engage our cognition to assess the situation, draw from past experience, and problem-solve to come up with an appropriate response. In healthy people, these dual systems work in tandem—one putting on the gas and the other applying the brakes—depending on what’s needed.

In the context of this process, a little bit of anxiety can have a positive side—like when it motivates us to practice hard to master a piano piece or study for a test. But, in anxious people, that gas pedal goes to the metal every time, making them want to run or flee challenge. It can be debilitating and exhausting, too, as they often have to exert a lot of effortful control just to get through. Facing stressful situations while tamping down that fear response is key to overcoming anxiety—in adults as well as older kids.

But in young kids, Fitzgerald and her team are discovering, the brain may respond a little differently. For example, four to seven-year-olds have a higher-than-normal startle response in “neutral situations”—where nothing threatening is happening—but have a normal startle response in scary situations that any child might react to. That suggests that they have more to overcome when facing everyday challenges, like going to school or meeting new people.

Her team has also discovered that a part of the brain that responds when people make a mistake—the error-related negativity (or ERN)—is weaker in anxious five to seven-year-olds than in worried older children and adults. That’s likely because young kids don’t have well-developed cognitive capacities that could help them understand that errors happen, aren’t scary, and can often be fixed. Without more cognitive control, their startle response wins out, making them anxious, says Fitzgerald.

A young child with low cognitive control is also more likely to develop anxiety later on in childhood, while one with a higher capacity will be more resilient to stress. Raising cognitive control (which can be measured by the ERN) could both treat anxiety in young children and potentially prevent it from becoming worse over time.

“If we could just help kids gain some cognitive control when they are anxious, it could really make a difference in how they deal with stressful situations,” says Fitzgerald. “We just need to empower them.”

Preventing harmful anxiety

To test this idea, Fitzgerald and her colleagues conducted a pilot study (as yet unpublished) with anxious four to seven-year-olds. The children came to a “camp” the researchers designed called Kid Power for four half-day sessions over two weeks. At the camp, children played fun, ordinary childhood games, like “Simon Says” and “Red Light/Green Light,” that help strengthen cognitive control.

Counselors at the camp gradually increased the challenge within the games to help kids master the skills needed to do well—like being flexible, using their working memory, and inhibiting undesirable responses (like moving when they’re supposed to freeze). They also enjoyed the company of other kids, with whom they brainstormed ways to improve their performance. And parents participated at the end of each session, learning the games from their kids so they could practice playing together at home.

To see the effects this training had on the kids’ brains and behavior, Fitzgerald and her colleagues measured their startle response and ERN before they attended the Kid Power camp and four to six weeks after. To do that, they had kids play computer games that required cognitive control while wearing special monitors that could capture their startle and ERN responses when they made mistakes. Additionally, the researchers gathered information from the parents and the kids themselves about anxiety symptoms before and after the camp.

After analyzing the data, the team found that the children’s ERNs increased (signifying greater cognitive control), while their startle responses went down—a pattern associated with less anxiety at that age.

“The brain signal that related to detecting an error actually increased, but in a good way,” said Fitzgerald. “Kids were getting better at doing hard things, stopping instinctual responding, including the fear response.”

This mirrored the children’s (and their parents’) own assessments. They reported fewer anxiety symptoms, including fear and avoiding challenging situations, after the training—something Fitzgerald found particularly rewarding.

“It’s exciting to link the brain to behavior, but what’s even more rewarding is the individual children we’ve seen go through the program who are experiencing fewer anxiety symptoms,” she says.

For example, one parent reported that her daughter, who’d had symptoms of the obsessive-compulsive disorder prior to attending the Kid Power camp, had made a noticeable improvement, even while the camp was still going on.

“She didn’t want to leave while she was here, and she was in a better mood during the week in between—a little less rigid and able to experience more joy,” the parent wrote in an evaluation.

Fitzgerald recalls another five-year-old camper who’d been very afraid of making mistakes in his kindergarten class, which led to bouts of crying and other disruptive behaviors, requiring daily calls home. After attending the camp, though, and learning how to calm anxiety, everything changed.

“After a week of playing those games that were part of the intervention, those calls from home stopped,” says Fitzgerald. “His mom was impressed because earlier counseling with a trained therapist had not led to improvement. Only after Kid Power did he successfully adjust to kindergarten and begin to enjoy it.”

With encouraging results from this pilot study, Fitzgerald applied for and received a $3 million National Institutes of Health grant to expand the Kid Power program and conduct further research. She hopes future studies will help her nail down the key ingredient in the program that led to reduced anxiety and, potentially, find a way to tailor treatment to individual children—some of whom may need a stronger dose of the training or slightly different activities to improve, she says.

If her initial findings hold, her work could have broad implications, providing a template that others can follow for treating and preventing childhood anxiety disorders in the future.

“Interventions are within reach,” she says. “As we work to understand the science behind anxiety in young minds, we can use that science to develop treatments that are more effective.”

This article was originally published by AIM Youth Mental Health, a non-profit dedicated to finding and funding promising youth mental health research that can identify solutions to make a difference in young people’s lives today, which contributed to funding Kate Fitzgerald’s research. Read the original article.

About the Author
{author}

Jill Suttie

Jill Suttie, Psy.D., is Greater Good’s former book review editor and now serves as a staff writer and contributing editor for the magazine. She received her doctorate of psychology from the University of San Francisco in 1998 and was a psychologist in private practice before coming to Greater Good.